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Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy.

Authors
  • Mishra, A K1
  • Sinha, V R1
  • Nilakantan, A1
  • Singh, D K1
  • 1 Department of Otorhinolaryngology - Head and Neck Surgery,Army Hospital (Research and Referral),Delhi,India. , (India)
Type
Published Article
Journal
The Journal of Laryngology & Otology
Publisher
Cambridge University Press
Publication Date
Jun 01, 2016
Volume
130
Issue
6
Pages
545–553
Identifiers
DOI: 10.1017/S0022215116001213
PMID: 27150223
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated. Twenty-six consecutive patients (15 males and 11 females) aged 28-72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management. At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund-Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups. Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.

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